Scottish Executive

Alcohol Misuse

Margaret Mitchell (Central Scotland) (Con): To ask the Scottish Executive how much has been allocated for the funding of local alcohol action plans, broken down by local authority area.

Mr Tom McCabe: We expect to announce specific funding for the implementation of local alcohol action plans in the first week in March. The release of funding is conditional on alcohol action teams having agreed outcome expectations and systems in place to measure key indicators. We will be monitoring the use of the new resources through alcohol and drug action team annual reporting arrangements.

  Funding for services addressing alcohol problems is provided within resources allocated to NHS boards and local authorities, but is not specifically identified by the Executive.

Eating Disorders

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive when it will provide dedicated residential facilities for people with eating disorders in each NHS board area and whether it will encourage the provision of independent sector facilities for people with eating disorders to add capacity to the NHS where boards are unable to provide such a service.

Malcolm Chisholm: NHS boards are responsible for assessing local service needs and for providing services to meet them, within the framework of national priorities and resources. I therefore look to boards, working together where appropriate, to determine the pattern of eating disorder services (including in-patient facilities) necessary to meet the needs of the areas they serve. This responsibility includes deciding how to make best use of services in the independent sector.

  The Framework for Mental Health Services in Scotland, published in 1997, sets out general guidance on eating disorder services and encourages boards to consider a range of approaches, including regional models, for providing access to in-patient care. The Framework does not impose a specific structure or level of service on boards. It is for the boards themselves to determine what is most appropriate in accordance with their assessment of local and regional needs and priorities.

Education (Additional Support For Learning) (Scotland) Bill

Mr Adam Ingram (South of Scotland) (SNP): To ask the Scottish Executive how much funding will be, or has been, allocated to advocacy services in respect of supporting the Education (Additional Support for Learning) (Scotland) Bill, broken down by (a) organisation and (b) location of organisation.

Mr Adam Ingram (South of Scotland) (SNP): To ask the Scottish Executive what process will be used when bidding for advocacy services in respect of the Education (Additional Support for Learning) (Scotland) Bill.

Peter Peacock: Through the Children, Young People and Families Unified Voluntary Sector Fund, £198,117 has been allocated to two organisations, ENABLE (£114,219) and Partners in Advocacy (£83,898), to develop advocacy services for children and young people with learning disabilities. The national office of ENABLE is located in Glasgow and the main office of Partners in Advocacy is in Edinburgh.

  We intend to invite further bids for grant funding for advocacy services to children with additional support needs and their families. An announcement of the bidding arrangements and funding will be made soon.

Health

Mr Kenneth Macintosh (Eastwood) (Lab): To ask the Scottish Executive what action it is taking to meet the desire of people with a life-limiting disease to die at home.

Malcolm Chisholm: Enabling patients to remain at home during the terminal stages of their illness, if possible and if that is their wish, requires integration of the specialist palliative care and primary healthcare teams. Managed clinical networks for palliative care promote that integration, which is why we support and encourage their development.

Health

Mr Kenneth Macintosh (Eastwood) (Lab): To ask the Scottish Executive whether the number of cancer deaths at home is rising or falling.

Malcolm Chisholm: The following table shows deaths from cancer by place of death from 1993 to 2002. It is reasonable to assume that deaths "not in an institution" are "at home".

  

 
 All Deaths
 Hospital, Nursing 
  Home, etc.
 Not in an Institution


 1993
 15,458
 11,413
 4,045


 1994
 15,164
 11,268
 3,896


 1995
 15,224
 11,247
 3,977


 1996
 15,171
 11,282
 3,889


 1997
 14,889
 11,098
 3,791


 1998
 14,752
 10,922
 3,830


 1999
 14,789
 11,142
 3,647


 2000
 14,958
 11,266
 3,692


 2001
 15,196
 11,435
 3,761


 2002
 15,051
 11,275
 3,776



  Source: GRO Scotland, February 2004. 2002 is the last year for which cancer mortality figures are available.

Health

Mr Kenneth Macintosh (Eastwood) (Lab): To ask the Scottish Executive what services are being put in place to support palliative care at home, including assisting with the control of pain and other symptoms, providing extra help for carers, meeting the need for nursing care in the home at night and providing advice and information through a telephone support service.

Malcolm Chisholm: We would expect NHS boards’ palliative care needs assessments to take account of these issues, and a number of initiatives are taking place across the country. The local and national reports from NHS Quality Improvement Scotland will help to achieve uniformity and equity of approach across the country as a whole in respect of these services and for those suffering from any progressive incurable illness.

Health

David McLetchie (Edinburgh Pentlands) (Con): To ask the Scottish Executive how many babies have (a) developed life threatening Group B streptococcal infections, (b) died due to Group B streptococcal infections and (c) survived but have been left with serious long-term mental or physical problems due to Group B streptococcal infections, in each of the last 10 years for which records are available.

Malcolm Chisholm: The available information on neonatal discharges recording Group B streptococcal infections is shown in the table for years 1996 to 2003.

  Discharges from Neonatal Units with Diagnoses of Group B Streptococcal (ICD10 P360) between April 1996 and March 2003:

  

 
 1996-97
 1997-98
 1998-99
 1999-2000
 2000-01
 2001-02
 2002-03*


 No of Discharges
 149
 236
 266
 224
 207
 256
 153



  Source: SMR11

  Note: *Incomplete data collection.

  The Number Of Deaths Of Children Aged Under Two, With A Mention Of Group B Streptococcus Infection On The Death Certificate, Between 1996 And 2003

  

 
 1996
 1997
 1998
 1999
 2000
 2001
 2002
 2003 
  2


 Mention of Group 
  B Streptococcus
Infection
 3
 2
 6
 3
 5
 5
 4
 2


  - of which










 underlying cause 
  of death involved Group B Streptococcus Infection1
 1
 1
 4
 2
 4
 4
 2
 2



  Source: General Register Office for Scotland

  Notes:

  1. Causes associated with Group B Streptococcus included meningitis, pneumonia, and septicaemia.

  2. Data for 2003 are provisional.

  Information on babies surviving but left with serious long term mental or physical problems due to Group B streptococcal infections is not readily available.

Health

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive what plans it has to increase the number of consultant dermatologists.

Malcolm Chisholm: Since 1997, the number of consultant dermatologists has increased by 16%. At 1.9%, the consultant dermatologist vacancy rate is below the national average consultant vacancy rate in Scotland of 5.6%.

  The number of specialist registrar training posts within this specialty has been increased from 14 in 2001 to 17 in 2003. Seven individuals are anticipated to achieve their Certificate of Completion of Specialist Training in 2004, with four in 2005 and five in 2006. This is the route which enables medical staff to apply for consultant posts.

  The findings of "The Temple Review" will inform work on medical workforce planning including in the area of dermatology.

Higher Education

Ms Rosemary Byrne (South of Scotland) (SSP): To ask the Scottish Executive, further to the answer to question S2W-5666 by Mr Jim Wallace on 28 January 2004, what the reasons are for the Open University increasing its fees to students when the Scottish Higher Education Funding Council has increased its grant to the University this year.

Mr Jim Wallace: The Open University is an autonomous institution and, as such, sets its course fee levels independently. However, I understand that the Open University has increased its course fees in line with inflation in the current year. Funding from the Scottish Higher Education Funding Council represents only one of the streams of funding available to the Open University.

Justice

Alex Neil (Central Scotland) (SNP): To ask the Scottish Executive when the fatal accident inquiry will commence into the circumstances surrounding the death of Stewart Williams while serving as a prisoner at Bowhouse Prison in Kilmarnock.

Mrs Elish Angiolini QC: The death of Stewart Williams on 30 January 2004 is being investigated by the Procurator Fiscal at Kilmarnock. In terms of section 1(1)(a)(ii) of the Fatal Accidents and Sudden Deaths Inquiry Act 1976 a fatal accident inquiry is mandatory. Investigation of the cause of death is still at an early stage and it is therefore not possible to set a date for the inquiry. Intimation will be sent to all interested parties at the relevant time in the usual way.

Justice

Karen Whitefield (Airdrie and Shotts) (Lab): To ask the Scottish Executive what action it plans to tackle high re-offending rates.

Cathy Jamieson: We have put the reform of the criminal justice system at the heart of our policies. The people of Scotland deserve strong, safe communities. To deliver this we must address the unacceptably high rate of re-offending we see in Scotland.

  Today I am launching Re:duce, Re:habilitate, Re:form – A Consultation on Reducing Reoffending in Scotland. This meets our partnership agreement commitment to consult on the establishment of a single agency to deliver custodial and non-custodial sentences.

  Over the next 12 weeks, officials from the Scottish Executive Justice Department and secondees from the Scottish Prison Service, local authorities and voluntary sector, will be undertaking a series of meetings, workshops and discussion groups to listen to the views of those with an interest in the criminal justice system. In particular, we will meet those who provide criminal justice services, victims of crime, offenders and their families, as well as representatives from communities which have been blighted by persistent offending. Written submissions will also be welcome.

  Copies of the consultation pack have been place in the Parliament’s Reference Centre (Bib. number: 31194). The pack is also available on the Scottish Executive website at:

  www.scotland.gov.uk/ReoffendingConsultation/.

Libraries

Richard Baker (North East Scotland) (Lab): To ask the Scottish Executive whether it is prepared to support the National Library of Scotland’s bid to secure the John Murray Archive.

Mr Frank McAveety: I am delighted to announce that, under Scottish ministers’ arrangements for supporting major purchases by the National Institutions in Scotland, the Scottish Executive will contribute £6.5 million towards the total cost of securing the John Murray Archive for the National Library of Scotland.

  The John Murray Archive is the most historically significant archive to become publicly available in the past hundred years containing extensive work by Byron, Scott, Darwin, Livingstone and countless other figures of global significance. It contains over 150,000 letters and manuscripts of the publishing firm founded in 1768.

  Acquisition of the archive will enhance the national and international cultural and educational reputation and image of Scotland, and enable the National Library to strengthen its already significant contribution to Scottish Executive priorities, including the promotion of Scotland worldwide, support for research, education and lifelong learning and the generation of economic benefits.

National Health Service

Scott Barrie (Dunfermline West) (Lab): To ask the Scottish Executive how many Distinction Awards were made by NHS Scotland in each year since 1999, showing whether the recipients were employed in (a) the Common Services Agency, (b) primary care, (c) teaching hospitals or (d) non-teaching hospitals.

Malcolm Chisholm: The table details how many Distinction Awards were made from 1999–2003 inclusive. The breakdown includes the number of awards made to those employed by the Common Services Agency and those employed in primary care trusts. A breakdown of the number of awards made to those in teaching and non teaching hospitals is not available.

  

 Awards
 Awards 
  Granted

 Awards 
  Granted to
 Employed


 Year
 A+
 A
 B
 Total
 Consultants 
  in PCTs
 by 
  CSA


 1999
 8
 19
 33
 60
 6
 2


 2000
 5
 19
 47
 71
 7
 1


 2001
 12
 34
 67
 113
 13
 1


 2002
 5
 22
 41
 68
 9
 0


 2003
 6
 17
 37
 60
 3
 2

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive what the cost has been of each investigation carried out by the NHS Fraud Investigation Unit since its inception and what the annual cost is of maintaining the unit and its helpline.

Malcolm Chisholm: The current running costs of NHSScotland Counter Fraud Services (CFS) are £550,000 per annum. The costs of the Fraud Hotline for the period April 2003 to date are £80. For that period, there were approximately 230 calls. This volume of calls can be dealt with by CFS staff as part of their normal duties.

  The CFS team is split into approximately 50% contractor investigations and 50% patient claims checking. To date, the CFS have carried out 56,000 patient exemption claims checks and 79 contractor investigations. Eleven have been referred to Procurators Fiscal, seven of which are still current. An investigation into contractor fraud may take between three and nine months depending on the complexity of the case (including the nature and scale of the fraud perpetrated, its location and the method/means used to carry it out) and on whether it is likely to be taken to court criminally or civilly or be subject to disciplinary procedures of the NHS or the professional regulatory bodies. The primary role of the CFS is deterrence and therefore, with the agreement of the NHS body, it may be decided that the most suitable action is not criminal prosecution but recovery of funds and/or discipline.

  A full exercise to cost all investigations carried out since the establishment of the CFS has not been undertaken. Resources would need to be diverted from investigative/prevention work in order to do so. Records are kept, however, of investigator time spent on every case. One case has been fully costed for investigators’ time and expenses resulting in a cost of £24,400. In this case, the practitioner pleaded guilty to a reduced charge of £6,000 fraud and has offered to make a further substantial repayment. Additionally, subsequent to the execution of the search warrant on the practitioner’s premises, his payment claims to the NHS fell by £5,000 per month or a saving to the NHS of £60,000 per year.

  Some cases do not result in substantial recoveries but impact on NHS clinical governance. If the CFS were to be judged solely on financial returns then cases involving clinical practice would not be taken on by them. This would be unacceptable.

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive how much it estimates out-of-hours primary medical services will cost after 1 April 2004, broken down by NHS board area, and whether it will allocate resources to ensure that service levels in other areas of healthcare are not compromised after this date.

Malcolm Chisholm: Under the new GMS contract GPs have the option to transfer responsibility for delivering out-of-hours primary medical services to their NHS boards. NHS boards have until 31 December 2004 to plan for reprovision of out-of-hours service, by which time they should have alternative arrangements in place for these services.

  Boards’ plans are not yet sufficiently developed to provide precise cost estimates at this stage, although a national out-of-hours working group is working with boards to take this work forward.

  NHS boards are already receiving record increases in their allocations (an extra 7.7% in 2004-05 in real terms) to ensure that the highest standards of service provision can be maintained and improved upon in all areas.

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive whether the cost of delivery of healthcare by patient episode has risen in line with the increased allocation of resources in real terms.

Malcolm Chisholm: NHS Board allocations have increased in real terms by 15.8% since 1999-2000. This compares with the real terms increase in measurable unit costs, mainly in the acute sector, of 23% over the same period.

  The unit cost figure should be treated with caution as they do not fully reflect changes in patterns of activity or improvements in quality and quantity of care as a result of changing clinical practice. New data collection processes are being developed to improve the way in which activity and costs are recorded in the future, and some of this is brought out in the new acute data due to be published on 26 February 2004. This includes statistics on nurse-led clinics, out-patient operations/procedure etc. More information can be found on this link: http://www.isdscotland.org.

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive whether it will publish the results of its consultation with each NHS board on the effects and costs of the reduction of hours of junior doctors.

Malcolm Chisholm: Reducing the hours worked by junior doctors to ensure safe patient care is a key priority for NHS employers and presents significant challenges. The effects are far reaching and the necessary changes form part of a wider programme of service modernisation and redesign. We have not consulted NHS boards on the specific costs of the reduction of junior doctors’ hours. We are however in on-going discussion with NHS boards and regional workforce planners about the effects of modernising the medical workforce.

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive whether it will publish, prior to the Stage 1 debate on the National Health Service Reform (Scotland) Bill, its evidence to support its view that the bill is cost neutral in respect of the abolition of NHS trusts.

Malcolm Chisholm: The evidence supporting the view that the bill is cost neutral in respect of the abolition of NHS trusts was set out in a letter to the Finance Committee dated 21 October 2003 and in a letter to the Health and Community Care Committee dated 24 February 2004.

National Health Service

Mr David Davidson (North East Scotland) (Con): To ask the Scottish Executive what patient consultation it has completed with regard to its proposal to abolish local health care councils and what consultation has been conducted with regard to the independence of the new Scottish Health Council.

Malcolm Chisholm: Proposals for a New Public Involvement Structure for NHSScotland issued for national consultation in March 2003. The proposals were developed following an extensive pre-consultation exercise with the key stakeholders; local health councils, the Scottish Association of Health Councils and the NHS. The consultation document, the comments received, and an independent analysis of the comments received can be viewed on Scottish Health on the Web at www.show.scot.nhs.uk/scottishhealthcouncils.

  This consultation covered issues relating to the status and independence of the Scottish Health Council.

National Health Service

Shona Robison (Dundee East) (SNP): To ask the Scottish Executive what additional funding has been made available to NHS Counter Fraud Services (CFS) to tackle fraud in the NHS; how such additional funding has been utilised, and how many investigations into CFS has carried out since it received additional funding.

Malcolm Chisholm: Funding of £1.1 million to support the expanded remit of NHSScotland (CFS) will be made available in the next financial year. In November, I approved the recommended option of a Short Life Working Group set up to prepare an options paper in respect of the extension of the CFS’s counter fraud role from family health services to the whole of the NHS in Scotland. That option was the provision of a full counter fraud service to NHSScotland, to include more extensive pro-active deterrence activities, through a centrally based, professionally qualified team of counter fraud specialists dedicated only to counter fraud work. The CFS is currently considering the practical aspects of expanding its remit, including office accommodation needs and recruitment, induction and training of additional staff, working with NHS boards to agree co-operative arrangements. For this purpose, it has set up an extended role project team composed of existing staff. Once arrangements are completed, the CFS will focus on its extended role. I should emphasise that there will be a concentration on deterrence and prevention activities to reduce fraud in the NHS to an absolute minimum alongside investigative activity. In the interim period, the CFS will continue with its work of countering fraud in the family health services.

Nursing

Mr Kenneth Macintosh (Eastwood) (Lab): To ask the Scottish Executive what steps it is taking to increase the number of nurses with specialist qualifications in palliative care.

Malcolm Chisholm: NHS boards are responsible for planning services in their areas and for securing the staff needed to deliver them.

  The Executive remains committed to building the workforce capacity of NHSScotland and in order to assist NHS employers meet local health needs, we have invested record sums in health.

  We are aware of the capacity issues for some specialist staff, and the department is working closely with NHSScotland to identify and increase the numbers of specialist nurses in palliative care.

Scottish Qualifications Authority

Margaret Smith (Edinburgh West) (LD): To ask the Scottish Executive when the Scottish Qualifications Authority (SQA) will review fees paid to markers.

Peter Peacock: Markers’ fees are reviewed annually by the SQA in October for the following year’s examinations round. The payment of markers’ fees is an operational issue and as such is a matter for the SQA.

Students

Fiona Hyslop (Lothians) (SNP): To ask the Scottish Executive how many undergraduates have declared themselves bankrupt in each year for which figures are available.

Fiona Hyslop (Lothians) (SNP): To ask the Scottish Executive how many undergraduates have been declared bankrupt in each year for which figures are available.

Mr Jim Wallace: Information on the number of debtors subject to sequestration proceedings who are undergraduates is not held centrally.

Students

Fiona Hyslop (Lothians) (SNP): To ask the Scottish Executive how many student loan borrowers have declared themselves bankrupt in each year since student loans were introduced.

Mr Jim Wallace: Information on whether the bankruptcy proceedings in each case were the result of a petition by the debtor or one of his/her creditors is not held centrally.

  I refer the member to the answer given to question S2W-6052 on 2 March 2004 for the numbers of Scottish student loan borrowers who have been declared bankrupt. All answers to written parliamentary questions are available on the Parliament’s website, the search facility for which can be found at:

  http://www.scottish.parliament.uk/webapp/wa.search.

Students

Fiona Hyslop (Lothians) (SNP): To ask the Scottish Executive how many student loan borrowers have been declared bankrupt in each year since student loans were introduced.

Mr Jim Wallace: The number of Scottish student loan borrowers who have been declared bankrupt in each calendar year are detailed in the table.

  

 Year
 Number of Borrowers


 1990
 0


 1991
 0


 1992
 2


 1993
 3


 1994
 3


 1995
 6


 1996
 13


 1997
 31


 1998
 75


 1999
 142


 2000
 150


 2001
 194


 2002
 329


 2003
 429


 Total
 1,377



  Source: Student Loans Company